The proposed study will investigate rural-urban differences in rates of psychiatric disorder and service usage in children ages 6- 11 in two contrasting settings in Connecticut. Data on prevalence of disorder and need for services have recently been collected in the context of a needs assessment survey in the urban New Haven area. The proposed study will use a comparable two stage study design in a rural and small town administrative health region in eastern Connecticut. A sample of 1068 children will be identified through first stage screening of parents and teachers on two indicators of caseness. All positively screened children and a subsample of those negative on the screen will be reinterviewed with a protocol that includes a structured psychiatric diagnostic interview. Additional information on a number of school and family characteristics will be gathered in the first and second stages to permit exploration of social and environmental correlates of psychiatric disorder in the two settings. An additional goal of the study will be to further the methodological and developmental work on child psychiatric screening and diagnostic measures. This will focus on the Diagnostic Interview Schedule for Children. We will focus on two issues: (1) the development of a teacher DISC for the systematic collection of symptom data from this important informant source, and (2) the assessment of test-retest reliability for this younger age group. The second stage of this prevalence survey provides an excellent opportunity for these methodological sub-studies. Use of a school-based sample will facilitate recruitment and interviewing of teacher respondents, and the second stage community sample will contain a relatively high proportion of symptomatic youngsters, which is a requirement for such methodological work. This study will take place in the context of a state sponsored psychiatric needs assessment effort for children. This research effort will provide a valuable opportunity to contribute to public health planning for children in need of psychiatric services.